Hospital Sign

TIT DO

aot FG

PB LKA

PASSPORT One® wpa Quit * Surname

RANAWEERA

00am a8 /Gougs @ Quunsea / Other see ¥

AGRM ARJUNA RAVIND R

HGadci&0a Gofur Meoni/ National Sta : se acs Gans Profession

SRI LANKAN & a

Cod Gna ins Pad/ Date of Birth iemri_wrst 9 s_ @e/ ID No.

23/09/1979 fe 156V

BEq6e men umm/ Sex @ \ if

M BEES 648 <

Cosi Gime Yngs Qi / Place of

KANDY MasSGiussisr suman / Holder's Sign

Gag og Cao supieds Dap B) ;

02/09/2022 Cg Gen Bbc

q8e0q, 82 Eno covesibianges Gale Date of Expiry

02/09/2032 eide silat / AUTHORITY COLOMBO

PBLKARANAWEERA<<A<G<R<M<ARJUNA<RAVINDRA

ees? &<5 KAT POSE ARRARR TESST 792671 756V 96

a pea ae

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